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By Michael Kelly Assistant Professor
Thomas Knickelbine, Lori Jia, Susan K White, Ross F Garberich, Sandra J Oberembt, Samantha Wills, Michael D Miedema, Emmanouil S Brilakis
BACKGROUND: Despite patient and provider interest, the use of PCSK9i therapy remains limited in clinical practice. High annual listed prices have created intense payer scrutiny and frequent health plan denials, with national approval rates in the range of 30% to 40%. OBJECTIVE: Our goal was to validate the strategies for increasing PCSK9i approval rates and to present a framework for successful PCSK9i prescribing in clinical practice. METHODS: In Sept 2015, a systematic team-based approach was developed and implemented at our institution...
January 16, 2019: Journal of Clinical Lipidology
Dhruv S Kazi, Joanne Penko, Pamela G Coxson, David Guzman, Pengxiao C Wei, Kirsten Bibbins-Domingo
Background: The ODYSSEY Outcomes (Evaluation of Cardiovascular Outcomes After an Acute Coronary Syndrome During Treatment With Alirocumab) trial included participants with a recent acute coronary syndrome. Compared with participants receiving statins alone, those receiving a statin plus alirocumab had lower rates of a composite outcome including myocardial infarction (MI), stroke, and death. Objective: To determine the cost-effectiveness of alirocumab in these circumstances...
January 1, 2019: Annals of Internal Medicine
Wenjun Fan, Sephy Philip, Craig Granowitz, Peter P Toth, Nathan D Wong
BACKGROUND: Statin therapy remains the primary treatment for mixed dyslipidemia, even with moderate triglyceride (TG) elevations. OBJECTIVE: We examined the prevalence of elevated TG levels in adults with and without statin use and the associated 10-year predicted atherosclerotic cardiovascular disease (ASCVD) risk. METHODS: We studied 9593 US adults aged ≥20 years (219.9 million projected) in the US National Health and Nutrition Examination Surveys, 2007 to 2014...
December 1, 2018: Journal of Clinical Lipidology
Anna V Mathew, Lei Li, Jaeman Byun, Yanhong Guo, George Michailidis, Mamta Jaiswal, Y Eugene Chen, Rodica Pop-Busui, Subramaniam Pennathur
OBJECTIVE: Phagocyte-derived myeloperoxidase (MPO) and proinflammatory HDL are associated with metabolic syndrome (MetS) and increased cardiovascular disease risk. Therapeutic lifestyle changes (TLCs), such as a Mediterranean diet and exercise, decrease this risk. However, the link among TLCs, HDL, and MPO-mediated oxidative stress remains unclear. RESEARCH DESIGN AND METHODS: In this study, we characterized changes in cholesterol efflux capacity (CEC), a metric of HDL function; MPO-mediated oxidation; and the HDL proteomic profile in 25 patients with MetS who underwent 12 weeks of TLCs...
November 2018: Diabetes Care
Jan Oscarsson, Kristina Önnerhag, Ulf Risérus, Mattias Sundén, Lars Johansson, Per-Anders Jansson, Linda Moris, Peter M Nilsson, Jan W Eriksson, Lars Lind
BACKGROUND: Treatment with omega-3 fatty acids and fenofibrates reduces serum triglyceride levels, but few studies have compared the effect of these agents on liver fat. OBJECTIVE: The aim of the EFFECT I trial (NCT02354976) was to determine the effects of free omega-3 carboxylic acids (OM-3CA) and fenofibrate on liver fat in overweight or obese individuals with non-alcoholic fatty liver disease and hypertriglyceridemia. METHODS: Seventy-eight patients were randomized to receive oral doses of 4 g OM-3CA (n = 25), 200 mg fenofibrate (n = 27), or placebo (n = 26) for 12 weeks in a double-blind, parallel-group study...
August 10, 2018: Journal of Clinical Lipidology
Sotirios Tsimikas, Sergio Fazio, Nicholas J Viney, Shuting Xia, Joseph L Witztum, Santica M Marcovina
BACKGROUND: Lipoprotein(a) [Lp(a)] is reported as Lp(a) particle mass (mg/dL) or molar concentration of apolipoprotein(a) [apo(a)] (nmol/L), which is considered the gold standard. Values are often converted from one measurement to the other but the validity of this is unknown. OBJECTIVES: To quantify the relationship between Lp(a) molar concentration and Lp(a) mass in the context of various Lp(a) level thresholds and apo(a) isoform size. METHODS: In all samples, Lp(a) levels in molar concentration and apo(a) isoform size were determined at the Northwest Lipid Metabolism and Diabetes Research Laboratories (NLMDRL)...
September 2018: Journal of Clinical Lipidology
Katia Gazzola, Marieke B Snijder, G Kees Hovingh, Erik S G Stroes, Ron J G Peters, Bert-Jan H van den Born
BACKGROUND: There is limited information on differences in plasma lipid levels among the major ethnic groups in Europe. OBJECTIVE: We investigated ethnic differences in plasma lipid levels in a large multiethnic cohort and explored the contribution of obesity and other determinants to ethnic differences in low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and triglyceride (TG) levels. METHODS: We compared lipid profiles among 21,617 participants (aged 18 to 70 years) of Moroccan, Ghanaian, South Asian Surinamese, African Surinamese, Turkish and Dutch ethnic origin, living in Amsterdam, the Netherlands...
September 2018: Journal of Clinical Lipidology
Ilse C Schrieks, Anna Nozza, Barbara E Stähli, John B Buse, Robert R Henry, Klas Malmberg, Bruce Neal, Stephen J Nicholls, Lars Rydén, Linda Mellbin, Anders Svensson, Hans Wedel, Arlette Weichert, A Michael Lincoff, Jean-Claude Tardif, Diederick E Grobbee, Gregory G Schwartz
OBJECTIVE: In observational cohorts, adiponectin is inversely associated and free fatty acids (FFAs) are directly associated with incident coronary heart disease (CHD). Adiponectin tends to be reduced and FFAs elevated in type 2 diabetes. We investigated relationships of adiponectin and FFA and major adverse cardiovascular events (MACEs) and death in patients with acute coronary syndrome (ACS) and type 2 diabetes using data from the AleCardio (Effect of Aleglitazar on Cardiovascular Outcomes After Acute Coronary Syndrome in Patients With Type 2 Diabetes Mellitus) trial, which compared the PPAR-α/γ agonist aleglitazar with placebo...
August 2018: Diabetes Care
Xavier Palomer, Javier Pizarro-Delgado, Emma Barroso, Manuel Vázquez-Carrera
Increased plasma non-esterified fatty acids (NEFAs) link obesity with insulin resistance and type 2 diabetes mellitus (T2DM). However, in contrast to the saturated FA (SFA) palmitic acid, the monounsaturated FA (MUFA) oleic acid elicits beneficial effects on insulin sensitivity, and the dietary palmitic acid:oleic acid ratio impacts diabetes risk in humans. Here we review recent mechanistic insights into the beneficial effects of oleic acid compared with palmitic acid on insulin resistance and T2DM, including its anti-inflammatory actions, and its capacity to inhibit endoplasmic reticulum (ER) stress, prevent attenuation of the insulin signaling pathway, and improve β cell survival...
March 2018: Trends in Endocrinology and Metabolism: TEM
Michel R Langlois, M John Chapman, Christa Cobbaert, Samia Mora, Alan T Remaley, Emilio Ros, Gerald F Watts, Jan Borén, Hannsjörg Baum, Eric Bruckert, Alberico Catapano, Olivier S Descamps, Arnold von Eckardstein, Pia R Kamstrup, Genovefa Kolovou, Florian Kronenberg, Anne Langsted, Kari Pulkki, Nader Rifai, Grazyna Sypniewska, Olov Wiklund, Børge G Nordestgaard
BACKGROUND: The European Atherosclerosis Society-European Federation of Clinical Chemistry and Laboratory Medicine Consensus Panel aims to provide recommendations to optimize atherogenic lipoprotein quantification for cardiovascular risk management. CONTENT: We critically examined LDL cholesterol, non-HDL cholesterol, apolipoprotein B (apoB), and LDL particle number assays based on key criteria for medical application of biomarkers. ( a ) Analytical performance: Discordant LDL cholesterol quantification occurs when LDL cholesterol is measured or calculated with different assays, especially in patients with hypertriglyceridemia >175 mg/dL (2 mmol/L) and low LDL cholesterol concentrations <70 mg/dL (1...
July 2018: Clinical Chemistry
Sankar D Navaneethan, Jesse D Schold, Carl P Walther, Susana Arrigain, Stacey E Jolly, Salim S Virani, Wolfgang C Winkelmayer, Joseph V Nally
BACKGROUND: Recent data suggest a U-shaped association between high-density lipoprotein cholesterol (HDL-c) and death in chronic kidney disease (CKD). However, whether the increased mortality in patients with extreme levels is explained by specific causes of death remains unclear. OBJECTIVES: We studied the associations between HDL-c and cause-specific deaths in CKD. METHODS: We included 38,377 patients with estimated glomerular filtration rate 15-59 mL/min/1...
July 2018: Journal of Clinical Lipidology
Barak Zafrir, Ayman Jubran, Rawan Hijazi, Chen Shapira
BACKGROUND: Comprehensive data on severe hypertriglyceridemia (HTG) in the general population setting are limited and of importance due to the increase in metabolic risk factors and novel therapies under development. OBJECTIVE: To investigate contributing causes and outcomes of severe to extreme HTG. METHODS: Regional database retrospectively analyzed for subjects with severe HTG. Adverse outcomes were investigated in correlation to HTG severity, with follow-up initiating at first documentation of HTG > 1000 mg/dL...
July 2018: Journal of Clinical Lipidology
Peiwen Zhang, Chen Yang, Honghui Guo, Jiaji Wang, Shengqiang Lin, Huamei Li, Yan Yang, Wenhua Ling
BACKGROUND: The use of coenzyme Q10 (CoQ10) as an adjuvant treatment with routine clinical therapy against metabolic diseases has shown benefit. However, the effect of CoQ10 as a primary preventive agent against cardiovascular diseases (CVDs) has not been well studied. OBJECTIVE: The objective of this study was to investigate the effect of CoQ10 on CVD risk factors in dyslipidemic patients. METHODS: In this randomized, double-blinded, placebo-controlled trial, 101 dyslipidemic subjects without taking any hypoglycemic or hypolipidemic drugs were administrated to 120 mg CoQ10 or placebo daily for 24 weeks...
March 2018: Journal of Clinical Lipidology
Luis Masana, Josefa Girona, Daiana Ibarretxe, Ricardo Rodríguez-Calvo, Roser Rosales, Joan-Carles Vallvé, Cèlia Rodríguez-Borjabad, Montserrat Guardiola, Marina Rodríguez, Sandra Guaita-Esteruelas, Iris Oliva, Neus Martínez-Micaelo, Mercedes Heras, Raimon Ferré, Josep Ribalta, Núria Plana
While the impact of very low concentrations of low-density lipoprotein cholesterol (LDL-C) on cardiovascular prevention is very reassuring, it is intriguing to know what effect these extremely low LDL-C concentrations have on lipid homoeostasis. The evidence supporting the safety of extremely low LDL levels comes from genetic studies and clinical drug trials. Individuals with lifelong low LDL levels due to mutations in genes associated with increased LDL-LDL receptor (LDLR) activity reveal no safety issues...
March 2018: Journal of Clinical Lipidology
Eiichi Araki, Shizuya Yamashita, Hidenori Arai, Koutaro Yokote, Jo Satoh, Toyoshi Inoguchi, Jiro Nakamura, Hiroshi Maegawa, Narihito Yoshioka, Yukio Tanizawa, Hirotaka Watada, Hideki Suganami, Shun Ishibashi
OBJECTIVE: Type 2 diabetes is frequently complicated with atherogenic dyslipidemia. This study aimed to evaluate the efficacy and safety of pemafibrate (K-877) in patients with type 2 diabetes comorbid with hypertriglyceridemia. RESEARCH DESIGN AND METHODS: Patients were randomly assigned to three groups and received placebo ( n = 57), 0.2 mg/day pemafibrate ( n = 54), or 0.4 mg/day pemafibrate ( n = 55) for 24 weeks (treatment period 1). Subsequently, the patients received follow-up treatment for another 28 weeks (treatment period 2), in which the placebo was switched to 0...
March 2018: Diabetes Care
Handrean Soran, Yifen Liu, Safwaan Adam, Tarza Siahmansur, Jan H Ho, Jonathan D Schofield, See Kwok, Matthew Gittins, Michael France, Naveed Younis, J Martin Gibson, Paul N Durrington, Martin K Rutter
BACKGROUND: Statin therapy is recommended in type 2 diabetes (T2DM) although views on treatment intensity and therapeutic targets remain divided. OBJECTIVES: Our objectives were to compare the effects of high-intensity and moderate-intensity atorvastatin treatment on lipoprotein metabolism and inflammatory markers and how frequently treatment goals are met in high-risk T2DM patients. METHODS: Patients with T2DM and albuminuria (urinary albumin:creatinine ratio >5 mg/mmol, total cholesterol <7 mmol/L, proteinuria <2 g/d, creatinine <200 μmol/L) were randomized to receive atorvastatin 10 mg (n = 59) or 80 mg (n = 60) daily...
January 2018: Journal of Clinical Lipidology
Yukiko Hasegawa, Mika Hori, Tomoko Nakagami, Mariko Harada-Shiba, Yasuko Uchigata
BACKGROUND: Patients with type 2 diabetes mellitus (T2DM) often have hypercholesterolemia, and their serum low-density lipoprotein cholesterol (LDL-C) levels are not always well-controlled even by statin treatment. The glucose-lowering glucagon-like peptide-1 receptor agonists (GLP-1RAs) are reported to change the lipid profiles in T2DM patients, but their effects have been unclear. OBJECTIVE: We examined whether GLP-1RAs affect serum cholesterol levels in T2DM patients with/without statin treatment...
January 2018: Journal of Clinical Lipidology
Luis E Simental-Mendía, Antonio M Gotto, Stephen L Atkin, Maciej Banach, Matteo Pirro, Amirhossein Sahebkar
BACKGROUND: Soy supplementation has been shown to reduce total and low-density lipoprotein cholesterol, while increasing high-density lipoprotein cholesterol. However, contradictory effects of soy isoflavone supplementation on lipoprotein(a) [Lp(a)] have been reported suggesting the need for a meta-analysis to be undertaken. OBJECTIVE: The aim of the study was to investigate the impact of supplementation with soy isoflavones on plasma Lp(a) levels through a systematic review and meta-analysis of eligible randomized placebo-controlled trials...
January 2018: Journal of Clinical Lipidology
Aurélie Delacrétaz, Frederik Vandenberghe, Mehdi Gholam-Rezaee, Nuria Saigi Morgui, Anaïs Glatard, Jacques Thonney, Alessandra Solida-Tozzi, Stéphane Kolly, Sylfa Fassassi Gallo, Philipp Baumann, Sylvie Berney, Sandrine Valloton Zulauff, Jean-Michel Aubry, Roland Hasler, Karsten Ebbing, Armin von Gunten, Philippe Conus, Chin B Eap
BACKGROUND: Cardiovascular diseases and dyslipidemia represent a major health issue in psychiatry. Many psychotropic drugs can induce a rapid and substantial increase of blood lipid levels. OBJECTIVE: This study aimed to determine the potential predictive power of an early change of blood lipid levels during psychotropic treatment on long-term change and on dyslipidemia development. METHODS: Data were obtained from a prospective study including 181 psychiatric patients with metabolic parameters monitored during the first year of treatment and with adherence ascertained...
January 2018: Journal of Clinical Lipidology
Sandra Ofori, Sotonye Dodiyi-Manuel, Maclean R Akpa
BACKGROUND: Among high-risk individuals, statins are beneficial for primary prevention of cardiovascular disease (CVD). In Nigeria, currently, there are no CVD prevention guidelines, so the use of CVD risk estimation to guide statin therapy is left to the discretion of the physician. OBJECTIVE: The objective of the study was to compare 3 CVD risk estimation tools in the evaluation of patients presenting to a tertiary hospital in Nigeria. METHODS: Cross-sectional study involving 295 patients with any CVD risk factors but not taking statins...
November 2017: Journal of Clinical Lipidology
2017-10-23 22:25:55
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